Appealing in an Atlanta Workers’ Comp Claim

Atlanta workers are protected by Georgia’s workers compensation law. This law requires employers to buy insurance or to self-insure in case of an employee injury on-the-job. The goal of Georgia’s workers comp law is to protect workers financially in case of illness or injury. Insurers are paid premiums by employers for workers, and insurers are supposed to pay benefits to workers if an illness or injury happens. A workers’ comp insurer should provide coverage for medical bills, disability income, and other losses as defined by Georgia’s workers’ comp law.

In some unfortunate cases, however, insurers do not pay as promised. Insurers could deny a claim that should be covered, or could decline to pay for particular medical benefits which a worker needs as a part of his recovery process. When and if a worker does not get the benefits that he is entitled to, the injured employee should consult with an Atlanta workers’ compensation lawyer for help.

Appealing an Atlanta Workers’ Compensation Claim

Appealing a workers’ compensation benefits denial can be a complicated process. Employees need to know when they can appeal and whether they can appeal. Appeals must be submitted by the appropriate deadline and the process of making an appeal must conform with legal requirements under Georgia law. The process is an administrative appeals process, which means that a person appealing has to understand how Georgia’s workers’ comp laws establish a special appeals process.

Workers who appeal are not always successful. Just recently, an article was published by NBC addressing problems that workers face when appealing a denial of essential workers’ comp benefits. The NBC report indicated around 600,000 workers who had been denied medical care appealed between 2013 and 2015. These employees were trying to get coverage for treatment they needed for work-related injuries. Unfortunately, in close to 90 percent of cases, the decision of the insurer was upheld and the injured employee continued to be denied medical care.

These statistics came from California, where changes in the law in 2013 shifted oversight of the appeals process to private contractors who entered into agreements with the state. Different states have different policies and appeals processes. This does not mean, however, that it is necessarily easy to successfully appeal a denial of workers’ comp benefits in any state. Insurers are powerful and have a lot of expert advocates helping them to make arguments for why they should not have to pay. Victims who just want to get their medical care and try to get better should also have advocates to help them, which is why it is so important for those who have been harmed to hire an attorney to help them get workers’ comp benefits- especially if those benefits have been denied and an appeal has become necessary.

The Atlanta workplace accident lawyers at Sammons & Carpenter, P.C. can represent employees or their families after a workplace injury or death. Call today at (404) 814-8949 or contact us online to schedule your free consultation.